In recent years, the prevalence of myopia has continued to rise, with an expanding affected population, making it a significant public health challenge both in China and globally. Elongation of the axial length in myopic eyes can induce a series of pathological changes in intraocular structure and function, increasing the risk of blinding ocular diseases such as retinal pathologies. Since myopia is difficult to reverse once established, scientific intervention is necessary to control its progression and reduce the likelihood of ocular complications. As a current research focus in myopia control, the clinical application of orthokeratology lenses has attracted considerable attention. This article highlights that orthokeratology lenses, worn overnight, reshape the corneal curvature and create a myopic defocus signal in the peripheral retina. This mechanism effectively inhibits excessive axial elongation and slows myopia progression. Clinical evidence indicates that orthokeratology can reduce axial elongation by 30% to 50%, accompanied by a short-term increase in choroidal thickness. This article also analyzes the advantages and limitations of orthokeratology and explores its potential synergistic effects when combined with other interventions such as low-dose atropine. The aim is to provide key theoretical and practical references for clinical myopia control.

Oral squamous cell carcinoma (OSCC) is a common head and neck malignancy. Approximately 50% to 60% of patients with OSCC are diagnosed at a locally advanced stage (clinical staging III-IVa). Even with comprehensive and sequential treatment primarily based on surgery, the 5-year overall survival rate remains below 50%, and patients often suffer from postoperative functional impairments such as difficulties with speaking and swallowing. Programmed death receptor-1 (PD-1) inhibitors are increasingly used in the neoadjuvant treatment of locally advanced OSCC and have shown encouraging efficacy. However, clinical practice still faces key challenges, including the definition of indications, optimization of combination regimens, and standards for efficacy evaluation. Based on the latest research advances worldwide and the clinical experience of the expert group, this expert consensus systematically evaluates the application of PD-1 inhibitors in the neoadjuvant treatment of locally advanced OSCC, covering combination strategies, treatment cycles and surgical timing, efficacy assessment, use of biomarkers, management of special populations and immune related adverse events, principles for immunotherapy rechallenge, and function preservation strategies. After multiple rounds of panel discussion and through anonymous voting using the Delphi method, the following consensus statements have been formulated: 1) Neoadjuvant therapy with PD-1 inhibitors can be used preoperatively in patients with locally advanced OSCC. The preferred regimen is a PD-1 inhibitor combined with platinum based chemotherapy, administered for 2-3 cycles. 2) During the efficacy evaluation of neoadjuvant therapy, radiographic assessment should follow the dual criteria of Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 and immune RECIST (iRECIST). After surgery, systematic pathological evaluation of both the primary lesion and regional lymph nodes is required. For combination chemotherapy regimens, PD-L1 expression and combined positive score need not be used as mandatory inclusion or exclusion criteria. 3) For special populations such as the elderly (≥ 70 years), individuals with stable HIV viral load, and carriers of chronic HBV/HCV, PD-1 inhibitors may be used cautiously under the guidance of a multidisciplinary team (MDT), with close monitoring for adverse events. 4) For patients with a poor response to neoadjuvant therapy, continuation of the original treatment regimen is not recommended; the subsequent treatment plan should be adjusted promptly after MDT assessment. Organ transplant recipients and patients with active autoimmune diseases are not recommended to receive neoadjuvant PD-1 inhibitor therapy due to the high risk of immune related activation. Rechallenge is generally not advised for patients who have experienced high risk immune related adverse events such as immune mediated myocarditis, neurotoxicity, or pneumonitis. 5) For patients with a good pathological response, individualized de escalation surgery and function preservation strategies can be explored. This consensus aims to promote the standardized, safe, and precise application of neoadjuvant PD-1 inhibitor strategies in the management of locally advanced OSCC patients.

Objective To investigate the current status of work readiness and its influencing factors among patients returning to work after lung cancer surgery. Methods A retrospective study was conducted on young and middle-aged postoperative lung cancer patients who were treated at the Department of Thoracic Surgery, West China Hospital, Sichuan University from March to September 2023 and returned to their jobs. Data were collected through a general information questionnaire, readiness for return-to-work scale (RRTW), general self-efficacy scale (GSES), and simplified coping style questionnaire (SCSQ). Univariate and multivariate logistic regression analyses were used to explore the factors affecting the work readiness of patients returning to work. Results A total of 219 patients were included, with 59 males and 160 females aged 18-60 years. Among the postoperative lung cancer patients returning to work, 73.1% were in the active maintenance stage of return-to-work readiness with a RRTW score of (17.59±1.48) points, and 26.9% were in the uncertain maintenance stage with a RRTW score of (16.22±1.50) points. Multivariate logistic regression analysis showed that patients aged≤30 years (OR=52.381), employees of enterprises and institutions (OR=7.682), agricultural, pastoral, fishery, forestry laborers (OR=15.665), positive coping (OR=5.043), those with higher self-efficacy (OR=1.157) and engaged in physically demanding work (OR=2.449) had higher return-to-work readiness, while patients with≥2 children (OR=0.055), self-payment (OR=0.044), and those working more than 40 hours per week (OR=0.122) had lower return-to-work readiness. Conclusion The return-to-work readiness of young and middle-aged postoperative lung cancer patients needs to be improved, and occupation, job nature, main coping styles, general self-efficacy and other factors are associated with return-to-work readiness.

In recent years, the incidence of myopia has been increasing alongside the growing global population, emerging as a significant public health challenge worldwide. Individuals with myopia exhibit an elongated axial length, which leads to various structural and functional ocular changes, resulting in the risk of related eye diseases and, in severe cases, blindness. Unfortunately, once myopia develops, it is irreversible. The only way to prevent or slow its progression is through appropriate treatment. The current focal point in myopia prevention and control is the peripheral myopic defocus theory. This paper summarizes the relevant research on defocus incorporated multiple segments(DIMS)lenses, following a systematic analysis of the literature. It analyzes the advantages and disadvantages of DIMS compared to other myopia control methods, and discusses the application prospects and future directions of defocus lenses represented by DIMS, aiming to provide reference and guidance for the control of myopia progression in children and adolescents.

Objective To investigate the efficacy of Lishui Xiaozhong Granules combined with Conbercept for the treatment of diabetic macular edema(DME).Methods From December 2022 to June 2023,46 patients(46 eyes)with DME of spleen and kidney yang deficiency complicated with blood-stasis obstructing the eye collaterals syndrome admitted to Foshan Hospital of Traditional Chinese Medicine were selected as the study objects.According to the principle of single-blind randomized controlled trial,the patients were randomly divided into treatment group and control group by random number table method,with 23 cases(23 eyes)in each group.The control group was treated with intravitreal injection of Conbercept,and the treatment group was treated with oral use of Lishui Xiaozhong Granules on the basis of treatment for the control group.The course of treatment lasted 3 months and then a follow-up for 6 months was conducted.Before and after treatment,the two groups were observed int the changes of traditional Chinese medicine(TCM)syndrome score,best corrected visual acuity(BCVA,LogMAR),central macular thickness(CMT),mean vessel density(VD)of superficial capillary plexus(SCP)and deep capillary plexus(DCP)in macular area,and the amplitude density and the latency of P1 and N1 wave in the R1 ring of multifocal electroretinogram(mf-ERG).Results(1)After 1,3 and 6 month(s)of treatment,BVCA in the two groups was improved when compared with that at the previous observation time point(P＜0.05),and the improvement in the treatment group was superior to that in the control group after 1,3 and 6 month(s)of treatment(P＜0.01).(2)After 1,3 and 6 month(s)of treatment,the CMT of the two groups was lowered as compared with that at the previous observation time point(P＜0.05),and the decrease in the treatment group was significantly superior to that in the control group(P＜0.01).(3)After 6 months of treatment,SCP-VD and DCP-VD in the two groups showed no obvious changes when compared with those before treatment(P＞0.05),the differences between the two groups after treatment were no statistically significant,either(P＞0.05).(4)After 1,3 and 6 month(s)of treatment,the amplitude densities of P1 wave and N1 wave in the R1 ring of mf-ERG in the two groups were increased when compared with those at the previous observation time point(P＜0.05),and the latency of P1 wave and N1 wave was shortened when compared with that at the previous observation time point(P＜0.05),and the treatment group had stronger effect on increasing the amplitude densities and on shortening the latency than the control group(P＜0.01).(5)After 6 months of treatment,the scores of TCM syndromes in the treatment group were lowered(P＜0.05)while the scores in the control group showed no obvious changes as compared with those before treatment.The intergroup comparison showed that the decrease of TCM syndrome score in the treatment group was significantly superior to that in the control group(P＜0.01).Conclusion In the treatment of DME with spleen and kidney yang deficiency complicated with blood-stasis obstructing the eye collaterals syndrome,Lishui Xiaozhong Granules combined with Conbercept have no influence on improving the SCP-VD and DCP-VD,but the combined therapy exerts satisfactory efficacy on increasing BCVA and on improving macular oedema,retinal function in the macular area and systemic symptoms.

Objective:To explore the relevant factors affecting the accuracy of scanning glucose monitoring (FGM) technology in critically ill patients.Methods:A total of 53 patients who were admitted to the Intensive Care Unit (ICU) of the Second Affiliated Hospital of Soochow University and used FGM glucose monitoring from September 2022 to December 2023 were selected by means of a convenience sampling method. The paired data of arterial blood glucose and FGM glucose were analysed. The accuracy of FGM blood glucose measurement in critically ill patients was evaluated using Bland-Altman analysis. The blood glucose data were divided into two groups: the FGM monitoring accuracy group and the FGM monitoring non-accuracy group.. The t-test and χ2 test were used for the comparison of one-way analysis of arterial versus FGM accuracy among critically ill patients with different demographic characteristics. Logistic regression analysis was used to analyze the factors influencing the accuracy of FGM. Results:The results of Bland-Altman analysis of the 53 patients indicated that the mean bias value of FGM blood glucose was elevated at 1.215 mmol/L in comparison with arterial-blood gas analysis blood glucose values. An incidence of exceeding the upper and lower limits of the range was observed, amounting to 6.349%. The discrepancy between the studies was found to be statistically significant (95% CI:1.0394~1.3908, P<0.001). The effects of the changes in height ( OR=0.877, 95% CI:0.780~0.987, P=0.029), changes in leukocyte counts( OR=0.917, 95% CI:0.868~0.969, P=0.002), changes in C-reactive protein( OR=1.009, 95% CI:1.002~1.017, P=0.016), changes in albumin counts( OR=0.986, 95% CI:0.974~0.999, P=0.031), and whether or not sepsis ( OR=3.937, 95% CI:1.192~13.008, P=0.025) on the accuracy of FGM had a statistically significant. Conclusion:The mean bias value of the accuracy of FGM was relatively higher compared with that of arterial blood gas analysis blood glucose values, and the influencing factors involved height, white blood cells, C-reactive protein, albumin, and whether or not sepsis was present. With the development of science and technology, applying the FGM system to critically ill patients has an absolute advantage in determining the overall glycemic trend, and the application value of FGM technology deserves further study.

Objective To investigate the current situation of career growth of public hospital managers and analyse its influencing factors,in order to provide a reference basis for promoting the level of career growth of hospital managers.Methods A convenient sampling method was applied to select 276 managers from nine public secondary and tertiary public hospitals in Hubei Province as the respondents,and a General Information Questionnaire,Career Growth Scale,and Person-organisation Fit scale were used to conduct the survey.Descriptive statistics,ANOVA,Pearson correlation analysis,and multiple linear regression were used to complete the analysis of the current status of career growth and influencing factors.Results The overall score of hospital managers'career growth is 3.29±0.79;person-organisation fit scores were positively correlated with hospital managers'career growth scores(P＜0.05).Multiple linear regression results showed that the type of hospital,the gender,whether or not they were both hospi-tal functionaries and clinical operations personnel,and the person-organisation fit were the major factors influencing the career growth of hospital managers the(P＜0.05).Conclusion The career growth of hospital managers is general-ly at an intermediate level and is affected by a variety of factors.Hospitals should pay attention to the individual characteristics and job requirements of managers,and improve career growth by completing the performance evalua-tion system,creating a good and fair organisational atmosphere,and easing career promotion stress.

Objective To observe the effects of Xuanfei Tongfu formula on the prognosis of patients with severe pneumonia.Methods Sixty patients with severe pneumonia admitted to the First People's Hospital of Fuyang District,Hangzhou City from June 1,2022 to April 1,2024 were selected as the research subjects.Patients were divided into control group(31 cases)and observation group(29 cases)by randomly number table method.Upon hospital admission,the control group received conventional Western medicine treatment,while the observation group received Xuanfei Tongfu formula in addition to conventional Western medicine treatment[Rhubarb 8 g(decocted later),Aurantii Fructus Immaturus 12 g,Magnoliae Officinalis Cortex 12 g,Agastache Rugosa 10 g,Tatarian Aster Root 15 g,Natrii Sulfas Exsiccatus 10 g(dissolved in water),decocted to 150 mL each time and taken],once a day for 5 days.Observe the changes of inflammatory indicators such as serum levels of C-reactive protein(CRP),procalcitonin(PCT),interleukin-6(IL-6)in both groups before and after treatment.To evaluate the severity indicators of diseases such as acute physiology and chronic health evaluationⅡ(APACHEⅡ)and sequential organ failure assessment(SOFA),as well as the clinical efficacy after treatment.Record the duration of mechanical ventilation,intensive care unit(ICU)length of stay and total hospitalization length of the two groups,calculate the oxygenation index level,and statistically analyze the 28-day survival rate.Results Compared with before treatment,the levels of inflammatory indicators CRP,PCT,and IL-6,as well as the scores of APACHEⅡand SOFA in both groups were significantly lower than those after treatment,the oxygenation index was significantly higher than that before treatment,and the changes in the observation group were more obvious than those in the control group[CRP(mg/L):28±17 vs.50±34,PCT(μg/L):2.0±1.5 vs.4.1±2.7,IL-6(ng/L):52±28 vs.97±61,APACHEⅡscore:12.8±5.1 vs.16.1±6.1,SOFA score:3.9±1.8 vs.6.2±2.7,oxygenation index(mmHg,1 mmHg≈0.133 kPa):302±57 vs.252±85,all P<0.05].Compared with the control group,the observation group exhibited a markedly reduced duration of mechanical ventilation(days:8.3±3.8 vs.11.4±6.4,P<0.05),and a significantly higher total effective rate of clinical efficacy[82.76%(24/29)vs.54.84%(17/31),P<0.05].Conclusion The application of Xuanfei Tongfu formula can effectively enhance the clinical treatment outcomes for severe pneumonia,reduce systemic inflammatory responses,promote organ function recovery,and improve the prognosis of patients.

AIM:To investigate the expression of AU-rich element RNA-binding factor 1(AUF1),an RNA-binding protein,in hepatocellular carcinoma(HCC),and to explore its potential role in HCC progression through regula-tion of metabolism-related genes.METHODS:A tissue microarray containing 99 HCC samples and 95 adjacent nontu-morous liver tissues was used to assess AUF1 expression.The associations between AUF1 expression and HCC clinical pa-rameters were analysed using the GEPIA and UALCAN databases.The AUF1 gene was knocked down in human hepato-blastoma HepG2 cells by siRNA,and transcriptomic and TMT quantitative proteomic analyses were performed to identify alterations in metabolism-related genes.RESULTS:The AUF1 expression was significantly elevated in HCC tissues and correlated with a poor prognosis.Knockdown of AUF1 in HepG2 cells resulted in reduced cell viability and increased apop-tosis.Integrative analyses of transcriptomic and proteomic data revealed that AUF1 knockdown in HepG2 cells led to up-regulation of carboxylesterase 3(CES3),fibrinogen gamma chain(FGG)and 4-hydroxy-2-oxoglutarate aldolase 1(HOGA1),and down-regulation of lamin B receptor(LBR),riboflavin kinase(RFK),sterol O-acyltransferase 1(SOAT1)and TWIST neighbor(TWISTNB).Clinical data from GEPIA and UALCAN databases suggested that the expression of these metabolism-related genes in HCC patients exhibited an opposite trend.CONCLUSION:Our findings suggest that AUF1 is highly expressed in HCC,and may contribute to tumor progression and poor prognosis by modulating the expres-sion of a series of metabolism-related genes.

Medical imaging technology is essential for the diagnosis and prognostic evaluation of cervical cancer.With the rapid development of imaging technology,multimodal imaging which combines the advantages of various imaging techniques to obtain more comprehensive and accurate diagnostic information for precise diagnosis and treatment is served as a new imaging method for the diagnosis of cervical cancer.Meanwhile,near-infrared fluorescence imaging occupies an important position in multimodal imaging for its advantages of high sensitivity and low invasiveness.Starting from the probe of near-infrared fluorescence mediated multimodal imaging,the study explores the applications and future prospects of multimodal imaging methods combining near-infrared fluorescence imaging with different imaging techniques such as magnetic resonance imaging,computed tomography and photoacoustic imaging in the preclinical basic research on cervical cancer.